MEDICARE: DR. ALEXANDER K MAMMEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	36849	MO

General Provider Information

NPI Number	:	1609874734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER K MAMMEN M.D.

Provider Business Mailing Address
First Line	:	4530 LEMAY FERRY RD
Second Line	:	SUITE M
City	:	SAINT LOUIS
State	:	MO
Zip	:	63129-1600
Country	:	US
Telephone Number	:	314-487-8724
Fax Number	:	314-487-0443

Provider Business Practice Location Address
First Line	:	4530 LEMAY FERRY RD
Second Line	:	SUITE M
City	:	SAINT LOUIS
State	:	MO
Zip	:	63129-1600
Country	:	US
Telephone Number	:	314-487-8724
Fax Number	:	314-487-0443

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	10/16/2017

Similar Medicare Providers

1508862533 — COMMUNITY CARE CENTER OF LEMAY, INC
Practice Location Address:

9353 S BROADWAY
SAINT LOUIS, MO
63125-1600

Practice Phone: 314-631-0540
Practice Fax: 314-631-5056

1386633360 — DR. TERRI LYNN RIUTCEL MD
Practice Location Address:

1600 S BRENTWOOD BLVD , DIV NEUROLOGY SLEEP MED, STE 600
SAINT LOUIS, MO
63144-1320

Practice Phone: 314-362-1408
Practice Fax: 314-747-4342

1063475523 — DR. JEAN E BIRMINGHAM M.D.
Practice Location Address:

1600 S BRENTWOOD BLVD , SUITE 100
SAINT LOUIS, MO
63144-1320

Practice Phone: 314-918-8827
Practice Fax: 314-918-9391

1437112570 — SUSAN E ADAMS M.D.
Practice Location Address:

1600 S BRENTWOOD BLVD , SUITE 100
SAINT LOUIS, MO
63144-1320

Practice Phone: 314-918-8827
Practice Fax: 314-918-9391

1942226188 — DR. AMY D BERTELSON PHD
Practice Location Address:

1600 S BRENTWOOD BLVD , DIV NEUROLOGY SLEEP MED, STE 600
SAINT LOUIS, MO
63144-1320

Practice Phone: 314-362-1408
Practice Fax: 314-747-4342

1710905435 — DR. KELVIN A YAMADA MD
Practice Location Address:

1600 S BRENTWOOD BLVD , SUITE 600
SAINT LOUIS, MO
63144-1320

Practice Phone: 314-362-4342
Practice Fax: 314-747-3813

Directions to “ DR. ALEXANDER K MAMMEN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.